December 13th, 2011 by Dinah Miller, M.D. in Opinion
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In yesterday’s post on e-prescribing, the issue of patient confidentiality came up in the context of doctors being able to see a patient’s full medication history in an electronic program, and one commenter brought up that she doesn’t necessarily want to tell her shrink about a yeast infection, perhaps because she finds it embarrassing. The writer of the post, a guest blogger, suggested that this might lead to useful information that should be addressed in therapy, for example the patient’s sexual life.
Years ago, I remember being a bit taken back when a patient brought up some rather problematic (to him) sexual issues in his marriage. It wasn’t the nature of the issues that surprised me (I spent more than a decade consulting to a sexual behaviors unit and I spent several months of residency training on an inpatient sexual disorders unit: it takes a lot to shock me). What surprised me was that this was the first I was hearing about this issue after seeing the patient for 5 years of psychotherapy. He had a secret life.
There’s not really much to do about this. One can only Read more »
*This blog post was originally published at Shrink Rap*
October 28th, 2011 by DavidHarlow in Opinion
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I’m back from my pilgrimage to Rochester, MN for the Third Annual Health Care Social Media Summit at the Mayo Clinic, presented by Ragan Communications. I had a great time, and want to share the experience with you. So please take a look at the archived #mayoragan tweets, my presentation on health care social media and the law, and my blog posts about the pre-conference and the summit itself posted at HealthWorks Collective. Here are some excerpts:
Mayo Ragan Social Media Summit Pre-Conference:
A recurring theme in my hallway conversations [today] was that it is impossible to transplant a successful program from one location to another without taking into account myriad local conditions (social media program, heart transplant program – same problem). As I always say to folks Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
October 10th, 2011 by DavidHarlow in Health Policy, News
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On September 14, HHS released for comment draft lab results regulations that will, if finalized, effectively bathe the Achilles’ heel of health data in the River Styx of ¡data liberación! All lab results will be made available to patients, just like all other health data. (See the HHS presser and YouTube video from the recent consumer health summit. Todd Park, HHS CTO, is also the chief activist for what he calls ¡data liberación!)
Forgive me for mixing my metaphors (or whatever it is I just did), but even though there are just a couple dozen words of regulations at issue here, this is a big deal.
When HIPAA established a federal right for each individual to obtain a copy of his or her health records, in paper or electronic format, there were a couple of types of records called out as specifically exempt from this general rule of data liberation, in the HIPAA Privacy Rule, 45 CFR § 164.524(a)(1): psychotherapy notes, information compiled for use in an administrative or court proceeding, and lab results from what is known as a CLIA lab or a CLIA-exempt lab (including “reference labs,” as in your specimens get referred there by the lab that collects them, or freestanding labs that a patient may be referred to for a test; these are not the labs that are in-house at many doctors’ offices, hospitals and other health care facilities — the in-house labs are part of the “parent” provider organization and their results are part of the parents’ health records already subject to HIPAA).
(“CLIA” stands for the Clinical Laboratory Improvement Amendments of 1988, which established quality standards for certain laboratory testing.)
This carveout of lab results from patient-accessible records has long been a thorn in the side of the e-patient. This month, Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
August 2nd, 2011 by Dinah Miller, M.D. in Opinion
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In the Clinical Encounters case featured here two days ago, I presented the story of a psychiatrist who goes for a urological procedure and discovers that one of his former patients is the nurse assisting. People wrote in to suggest ways he should handle this awkward situation and I was struck by the idea that some suggested he tell the urologist that he knows the nurse in a social setting (because he can’t tell the other doc that the nurse was his psychiatric patient) and the assumption that the urologist would be understanding, and that perhaps the urologist should have policies in place in case of such events.
Do surgeons think this way? Read more »
*This blog post was originally published at Shrink Rap*
July 9th, 2011 by GarySchwitzer in True Stories
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Marilyn Mann is a very smart woman. She’s a securities lawyer. But she’s also educated herself about health care out of necessity. She’s a breast cancer survivor and she has a daughter with heterozygous familial hypercholesterolemia, a genetic disease causing very high LDL-cholesterol. She is one of the administrators of a Facebook group called Familial Hypercholesterolemia (FH) Discussion Group – intended primarily for people with FH or their family members.
Recently, Mann got a message from a PR woman who had joined the Facebook page.
“Hi Marilyn,
A few months ago, I had emailed you about some research I was doing about a new treatment for FH. I am now working with a pharmaceutical company, and the company currently has a drug in development to help treat people with severe FH that may not be responding to current therapies. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
